How can people dispose of old or excess medications and drugs?
There are three options that you can use to dispose of drugs:
If you use a takeback program, how do officials dispose of the drugs they receive?
If it is a takeback event or it's part of the Colorado Medication Takeback Program, those drugs are all incinerated. Incineration is expensive, and we don't have an incinerator in Colorado that's approved by the EPA for drugs currently, so everything has to be shipped out of Colorado for incineration.
What are the dangers of throwing prescription drugs into the regular trash, pouring them down the drain or flushing them down the toilet?
It’s a serious pollution risk. Flushing medications down the toilet will immediately put them into our waste water. Importantly, our water treatment systems aren’t made to pull drugs out of the wastewater. There are several studies that have found drugs in fish and plants in the waterways of Colorado. That’s why both state health leaders and the FDA have said for many years, do not flush medications.
So, you might think the landfill is a good option. But even when it's in the landfill, it's possible those medications could leach into our water supply from runoff.
How do these home drug disposal systems work on a chemical level?
An effective at-home drug disposal system contains activated carbon or charcoal – they're basically the same thing. Activated carbon is very porous and has a great ability to adhere to drugs to make them irretrievable and not able to be absorbed into your body or the environment.
When we think about activated charcoal, there's a lot of fads of people using it, swallowing it and trying to eliminate toxins. Now, there’s no data or evidence for those uses, but we do know that it's very effective at adhering to – and deactivating – most drugs.
What drugs should you avoid using in a home drug disposal system?
There's a few, and some are called Resource Conservation and Recovery Act drugs. They're hazardous waste drugs. That includes things such as:
- Chemotherapy drugs
- Epinephrine
- Warfarin
- Nicotine (patches and gum, for example)
- Some vaccines, eye drops, nasal sprays
These drugs should go to drug disposal programs. And of course, don't put syringes into these at-home disposal systems. Sharps should follow specific disposal directions.
Some other exceptions to be aware of: Obviously, inhalers won’t work in these systems. And no vials of drugs. If it's in a glass vial or a pen, even if it doesn't have needles with it, they cannot be deactivated with one of these systems. Empty insulin vials, however, can be thrown out in the regular trash.
Do home drug disposal systems have a listed limit to how much they can deactivate?
Yes. There is a maximum adherence property of the activated carbon. So given the maximum adherence property, these have been formulated in sizes for a certain volume of drugs or number of pills. Ensure you are not overcrowding the disposal system pouch or bottle and follow all the directions closely.
For the pouches, warm water is important?
Yes. Warm water will help dissolve the tablets and capsules, so the carbon can adhere itself to the drugs. Make sure to fill the pouch as instructed with the correct amount of water.
If there's any accidental spillage, would you recommend that people contact a poison control center – just out of an abundance of caution?
Out of an abundance of caution, yes, I’d recommend contacting a poison control center. But these at-home systems should be safe if you are following the directions on the packaging. If ingested, these are made to cause vomiting and won’t taste great to begin with.
Are there any contamination concerns when these at-home disposal systems are thrown in the trash?
It is safe to be in a landfill. The carbon is safe by itself. The drug is then adhered to the carbon, so the drug is not available to go into the water and soil. Certain pouches are made from degradable material and will breakdown slowly over time.
After adding the drugs, it’s impossible to tell if the process is complete. So it’s better to seal the bottle or pouch and put it in the trash and leave it alone.
Have you done any informal testing with your colleagues of these products?
Yeah, we tested three different ones, one of the pouch systems and two plastic bottle systems.
We noticed that one plastic bottle system did not appear to have activated carbon and did not sufficiently make the drug irretrievable. I’d recommend if people seek these out online, to ensure the one they are buying has activated carbon.
Another plastic bottle system had liquid inside, and you just add your drugs directly in and it worked great at deactivating the drugs. You can keep using this system until it reaches the fill line.
The pouches did not work very well with cold water. Use warm – not boiling – water with these pouches. Compared to the bottle systems, they are also one-time use – as soon as you add drugs and seal it, that’s it. They also appeared to take a little longer than the above plastic bottle system to naturally degrade the drugs.
What role do you see these at-home disposal systems having in the broader conversation around drug safety and the disposal ecosystems?
I think these are a great choice for someone who has a small amount of medication, particularly controlled substances like opioids, that they want to dispose of rather quickly. The at-home drug disposal systems are small, they're easy to store and they can be purchased or obtained at the time of the prescription. They're also eco-friendly.
The takeback events are helpful, and the drug medication takeback boxes that we have supported by CDPHE and funded by the Legislature, those are great options. But it might be more convenient for someone who has a small prescription of a pain medication or other controlled substance to dispose of it using one of these at-home methods.
Conversely, I think a takeback event or one of the medication takeback boxes may be better for someone who, for example, has a family member pass away and they have many medications they need to dispose of. Lots of older adults have accumulated medication over time – including for pets – and it's always a good idea to dispose of those medications in the safest and most convenient way, which is all at the same time and through the medication takeback kiosks or a DEA takeback event.
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